First Author: A.Neves PORTUGAL
Co Author(s): A. Cardoso S. Mendes J. Campos A. Campos J.P.C. Sousa 0 0 0 0 0 0 0 0 0
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To report a case of a 20-year-old female with decreased visual acuity (VA) for three days in the left eye (LE).
Ophthalmology Department, Santo André Hospital, Leiria Hospital Center, Portugal.
Retrospective descriptive study of a case report based on information from clinical records, patient observation and analysis of complimentary diagnostic tests.
A 20-year-old female presented with decreased VA for three days in the LE. The best corrected visual acuity (BCVA) was 10/10 in right eye (RE) and 5/10 in LE. Pupillary function, intraocular pressure, results of external segment examinations and slit-lamp biomicroscopy were normal, bilaterally. RE fundoscopy was normal and in the LE revealed papillitis and posterior pole exudative retinal detachment. Optical coherence tomography (OCT) confirmed the macular serous retinal detachment and showed thickening of the posterior choroid, also revealed by orbital ultrasound and magnetic resonance imaging (MRI). Fluorescein angiography revealed angiographic features typical of VKH disease: diffuse choroiditis, serous retinal detachment, focal areas of delayed choroidal perfusion and multifocal areas of pinpoint leakage. Serological testing for the diagnosis of infectious pathologies was negative and review of systems was normal. The patient received systemic corticosteroid therapy combined with cyclosporine. After 4 months treatment, LE BCVA was 10/10, with completely reabsorption of subretinal fluid and normal retinal and choroidal thickness confirmed by OCT.
Despite the unilateral involvement, the clinical and angiographic features were typical of VKH disease. Ophthalmologists should be aware to recognize unilateral VKH disease, even though it is a rare clinical variant of the disease.